Evaluación económica de tecnologías en salud

Cost Effectiveness of Combination Therapy Versus Monotherapy in Benign Prostatic Hyperplasia: A Colombian Experience.
Autores: César Augusto Guevara - Cuellar, Elizabeth Parody - Rúa, Herney Andres Garcia - Perdomo, Andrea Arenas -Duque.
Journal: Value in Health Regional Issues
Publicado: Diciembre 2018.

Objetives: To estimate the incremental cost effectiveness ratio of pharmacological treatment for benign prostatic hyperplasia from the payer's perspective. Methdos: The cost effectiveness of 5 mg finasteride, 0.5 mg dutasteride, 10 mg alfuzosin, 10 mg terazosin, 0.4 mg tamsulosin, 4 mg doxazosin, and the combination therapy of 5 mg finasteride and 8 mg doxazosin was evaluated using a Markov model over a 30-year period. The costs were estimated using national tariffs and were reported in US dollars. Cost and effectiveness outcomes were discounted at a rate of 5% per year. Men (aged ≥40 years) with moderate to severe lower urinary tract symptoms and uncomplicated benign prostatic hyperplasia were included in the analysis. Outcomes included costs and quality-adjusted life-years. A probabilistic sensitivity analysis was performed on important parameters with Monte-Carlo simulation.

Budget impact analysis of the adoption of new hypertension guidelines in Colombia.
Autores: Cesar Augusto Guevara‑Cuellar, Victoria Eugenia Soto y María Isabel Molina‑Echeverry.
Journal: Cost Effectiveness and Resource Allocation.
Publicado: Septiembre 2018.

Hypertension represents a high burden of disease in different healthcare systems. Recent guideline published in 2017 by the American Heart Association and the American College of Cardiology has generated a debate between clinicians and policymakers due to the lowering of diagnosis threshold and the subsequent increase of the prevalence and healthcare costs. No empirical research exists addressing the question about the pressure on healthcare costs generated by new standards. This study aims to quantify the impact on the hypertension diagnosis and treatment costs for healthcare system using the new hypertension guideline.

Cost-effectiveness of meglumine antimoniate versus miltefosine caregiver DOT for the treatment of pediatric cutaneous leishmaniasis
Autores: Brandon A. Berger, Alexandra Cossio, Nancy Gore Saravia, María del Mar Castro, Sergio Prada, Allison H. Bartlett, Mai T. Pho.
Journal: PLOS Neglected Tropical Diseases.
Publicado: Abril 2017.

Author summary: Cutaneous leishmaniasis (CL) is a tropical parasitic disease transmitted by sand flies that causes chronic skin and mucosal ulcers. Current standard of care therapy requires patients to travel to a clinic for twenty consecutive days for injections of meglumine antimoniate (MA). This may represent an economic burden, particularly for patients living far from healthcare services, especially children and their caregivers. We performed mathematical modeling to compare costs of the standard of care treatment with costs of miltefosine, an equivalently efficacious oral medication that allows pediatric patients to be treated at home under trained supervision of a caregiver. In our model, miltefosine led to substantially lower costs for patients and only slightly higher costs to the healthcare system. Importantly, the cost to society (combined patient and healthcare system costs) was lower for miltefosine compared to MA. Treatment of pediatric CL with miltefosine in the patient’s home could decrease overall cost of treatment, while diminishing the barriers and cost burden on patients, their caregivers, and society.

Cost-Effectiveness of the Quantification of Enzymatic Activity in Leukocytes in Comparison to Its Nonrealization for a Rare Disease in Latin America: The Case of Mucopolysaccharidosis Type II in Colombia.
Autores: Elizabeth Parody, Cesar A. Guevara, Andrés Aguirre, Paula M. Tello.
Journal: Vakue ub Health Regional Issues.
Publicado: Abril de 2016.

Objetivo: Determinar el costo-efectividad de la medida de la I2S actividad enzimática en los leucocitos sin llevar a cabo la medición de la actividad enzimática para la confirmación del diagnóstico de MPS II desde la perspectiva del sistema de la salud en Colombia.